Individual provider Active NPI

Laura L Gorman, PHD

  • Psychologist
  • Waterloo, IA
National Provider Identifier
1740218544
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
969 Issued in IA
Practice address
3421 W 9TH St
Waterloo, IA 50702-5401
Phone
(319) 272-7912
NPI assigned
Jun 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 969 IA Primary

Addresses

Primary practice location

3421 W 9TH St
Waterloo, IA 50702-5401

Mailing address

3421 W 9TH St
Waterloo, IA 50702-5401
Phone (319) 272-7303

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
00969IAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Family Treatment Professionals, LLC PastSince Jan 29, 2014 Accepting new patients
Northeast Iowa Family Counseling PastSince Mar 1, 2014 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740218544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 W 9TH ST",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025401",
            "telephone_number": "319-272-7303",
            "fax_number": "319-272-7318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3421 W 9TH ST",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025401",
            "telephone_number": "319-272-7912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORMAN",
        "first_name": "LAURA",
        "middle_name": "L",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IA",
            "license": "969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.